Fit for Purpose: Introducing data mapping for a healthier NHS
Gemma Platt, managing executive for Vigilant Software, explores the challenges of data-sharing in the NHS and how data mapping could provide much needed clarity and better GDPR compliance
There is an overwhelming amount of data collected and stored in the NHS. On one hand, it can be an incredibly useful indicator about the effectiveness of service delivery, helping to inform future health programmes and improve diagnoses and treatment. However, the abundance of information could present a very real threat to security and compliance if it is not monitored and managed appropriately.
Public confidence in data-sharing has been tested in recent years by several high-profile breaches. In 2017, the global WannaCry attack led to nearly 20,000 cancelled hospital appointments in the UK. The Department of Health and Social Care (DHSC) estimates the breach cost the NHS £92m in direct costs and lost output as a result of disruption to services. This doesn’t factor in the penalties that could have been levied by GDPR, or the class action lawsuits from patients that could have followed.
The reason the NHS is such a rich target for cybercriminals is because it continues to rely on older technologies and operating systems, leaving them susceptible to attack. Earlier this year it was revealed that the NHS is still a major purchaser of fax machines, which have long been redundant in the private sector. Given the organisation is so sprawling and complex – and driven by the need to be cost-effective – it isn’t always possible to run the latest next-generation security tools, or integrate different moving parts in the most secure way.
What is certain is that the NHS would be unable to cope with enormous pay outs or fines in the aftermath of a serious incident. Could a severe cyberattack or data breach ultimately bring the end to free healthcare?
Mitigating risk with data mapping
Despite apprehensions around information security and compliance, the public still has faith in NHS organisations to manage patient data, and there is still strong support for information being shared to improve patient care and research. It’s therefore imperative that the NHS has a handle on what data is being stored, how it is used and what protection is in place to keep it secure.
- Healthcare providers: The route to digital transformation success
- The future for digitised healthcare
- Top 10 healthcare innovations for 2019
Data mapping is about creating a visual overview of all the data collected and stored by an organisation, providing an insight into the potential risks associated with each data type and location. It doesn’t rely on data sources being exclusively available online, so it can account for the paper-based processes that are still inherent within the NHS.
There are several considerations that organisations need to be mindful of before embarking on data flow mapping. Personal data can reside in a number of locations and be stored in various formats; paper, electronic and audio. The first step is to decide what information needs to be recorded, and in what form factor. Next they need to identify what type of security measure – and the policy and procedures for its use – needs to be introduced, while also defining who controls access to it. The final challenge is to understand what the organisation’s legal and regulatory obligations are; this may include compliance standards such as the PCI DSS and ISO 27001, as well as the GDPR.
The steps to data mapping
Once there is an understanding of the data that is being recorded, where it’s stored and how it is being protected, the NHS can begin to chart the data flow. First you need to familiarise yourself with how and where the data moves in and outside the organisation.
Next, identify what kind of data is being processed - names, addresses, emails - and what format do you store the data in; is it hardcopy or digital? How are you collecting the data; is it through the post, telephone, email, and how do you share it, both internally and externally? What locations are involved in the data flow, and who is accountable?
Asking this series of questions allows technicians to see how information is being used, and hopefully foresee any inappropriate or unintended use of the data. It also demonstrates due diligence in information security and compliance, in accordance with GDPR.
We all know the value of data, and we’d be wise not to underestimate the challenge it presents for security and compliance. By having complete visibility and granularity on what information is available across an entire organisation, data processors can recognise threats earlier and mitigate risks before any damage can be done.
Long haul Covid, the brain and digital therapies
It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain.
Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain.
What is long Covid exactly?
Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.
How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!
When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover.
If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus.
The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.
What symptoms does this cause?
These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.
In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.
This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.
How does long-haul Covid affect mental health?
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.
How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.”
We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain.
We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and running half marathons again.
At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response.
The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival.
What digital therapies or apps are proving effective at treating long-haul Covid?
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy.
What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.